- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.81 / $82.06 / $618.38
| Facility | | $3.81 | $82.06 | $618.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.75 / $3.29
| Professional | | $2.73 | $2.75 | $3.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.28 / $18.43 / $36.70
| Facility | | $7.28 | $18.43 | $36.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.29 / $7.29 / $7.29
| Professional | | $7.29 | $7.29 | $7.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.13 / $3.13 / $34.14
| Facility | | $3.13 | $3.13 | $34.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.77 / $2.77 / $80.00
| Facility | | $2.77 | $2.77 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $2.73 / $2.73
| Facility | | $2.57 | $2.73 | $2.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $2.83
| Professional | | $2.73 | $2.73 | $2.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $593.63 / $593.63 / $593.63
| Professional | | $593.63 | $593.63 | $593.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.72 / $2.87 / $8.48
| Facility | | $2.72 | $2.87 | $8.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.78 / $4.50
| Professional | | $2.73 | $2.78 | $4.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $3.13 / $10.40
| Professional | | $2.73 | $3.13 | $10.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $2.86 / $7.81
| Facility | | $2.73 | $2.86 | $7.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $4.33
| Professional | | $2.73 | $2.73 | $4.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.89 / $3.04
| Professional | | $2.73 | $2.89 | $3.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $2.86 / $3.82
| Professional | | $2.72 | $2.86 | $3.82 |